Human papillomavirus (HPV)

There are many types of human papillomavirus (HPV), and more than 40 of them can be transmitted sexually. They include:

• “Low-risk” HPV infections, some of which cause genital warts, are rarely associated with cancer
• “High-risk” HPV infections, which are more likely to cause cancer

Most sexually active men and women will have an HPV infection at one point or another in their lives. People can be infected by more than one type of HPV during their lifetime. They may also be infected more than once by the same HPV.

Often, people who are infected do not have symptoms. This means that a person can be infected without knowing it.

Genital warts (a symptom of a low-risk HPV infection that is rarely associated with cancer)

Genital warts are soft growths (small bumps) that occur on the skin or mucous membrane:

• Of the genitals (penis, scrotum, vulva, vagina, anus)
• Of the throat (sometimes)

Genital warts appear between 3 weeks to several months or even years after the infection. Without treatment, they generally disappear within a few years, but they can reappear after several months or many years. Genital warts pose no health risks. They are neither cancerous nor precancerous.

Symptoms of high-risk HPV infections (infections that are more likely to cause cancer)

A high-risk HPV infection generally does not cause symptoms. In most cases, the immune system eliminates these infections within several months. In most women, it is impossible to detect the virus after 2 years. In a small number of infected women, the infection can last more than 2 years and cause cervical lesions. These lesions can cause abnormal bleeding – during sex, for example.

Each year in Québec, about 300 women are diagnosed with cervical cancer.

When to consult

If you have abnormal vaginal bleeding, or if you think that you have genital warts, you can call Info-Santé at 811 or consult with a doctor, who will conduct the necessary tests for a diagnosis.

In most cases, the immune system eliminates an HPV infection within a few months, but there is no effective treatment for the viruses responsible for HPV infections themselves. However, certain manifestations of both types of HPV infections can be treated.

Treatment for genital warts (a symptom of a low-risk HPV infection that is rarely associated with cancer)

There are certain treatments that can make genital warts disappear. These treatments, however, do not always eliminate the virus, which can persist after the genital warts have disappeared.

If you have genital warts, your doctor will assess whether a treatment is necessary and recommend an appropriate one if needed.

Treatment for high-risk HPV infections (those that are more likely to cause cancer)

If you have a high-risk HPV infection, your doctor will recommend the best treatment for your situation. The treatment aims to neutralize the virus to avoid the development of cancer cells. However, it does not guarantee it will be eliminated. If your doctor finds cancer, you will be referred to a specialist.

Inform partners

People with genital warts should inform their current sexual partners so that they can consult a health-care professional, who will determine whether, among other things, they should receive an HPV vaccine.

In certain cases, HPV infections can cause complications, which vary according to the type of HPV.

Complications of genital warts (a symptom of a low-risk HPV infection that is rarely associated with cancer)

A low-risk HPV infection does not cause precancerous cervical lesions. This type of infection does not increase the risk of cervical cancer. In certain people, however, it can lead to the following complications:

• Very big genital warts
• Bumps on the surface of the larynx, respiratory tract or vocal cords. This complication is rare and can affect young children, adolescents and young adults

Complications of high-risk HPV infections (those that are more likely to cause cancer)

• In women, these infections can cause cervical lesions, which can transform into cervical cancer. Lesions can also appear on the vagina or the vulva and lead to cancer in these areas.
• In men, these infections can cause lesions on the penis, which can transform into cancer.
• In both women and men, lesions can affect the anus and throat and lead to cancers in these areas.
• HPV increases the risk of an HIV infection.

A person with an HPV infection can transmit the virus even if there are no symptoms.

Transmission can happen during:

• Oral sex (contact of the mouth with the penis, vulva, vagina or anus)
• Vaginal sex (penetration of the vagina with the penis)
• Anal sex (penetration of the anus with the penis)
• Genital contact between partners
• Sharing of sex toys

Sexual transmission can occur in the absence of penetration, orgasm or ejaculation.

More rarely, an infected mother can pass the infection to her baby during childbirth.

Vaccination

Vaccination is the best way for people to protect themselves against HPV infections and their complications. In Québec, the HPV vaccine is given free of charge under the Québec Immunisation Program. People not eligible for the program can get the vaccine from their doctor, which they must pay for.

To learn more about the program and the vaccines available, read Human Papillomavirus (HPV) Vaccine.

Sexual protection

Condoms reduce the risk of HPV infections when used:

• During all contact between genital organs
• During the entire course of oral, vaginal or anal sex
• With each sexual encounter

The use of a sheet of latex to cover the vulva or anus during oral sex reduces the risk of spreading HPV infections. It helps prevent direct contact with the mouth. A sheet of latex can be made by unrolling a condom, cutting off both ends and then cutting it lengthwise.

However, the use of a condom or sheet of latex does not prevent the spread of HPV infection through contact with uncovered infected areas, such as:

• The vulva
• The scrotum

People who share sex toys can reduce the risk of spreading HPV by covering them with a condom. They must change condoms with each new partner.

Screening

If you have genital warts, see a doctor or nurse.

Cervical cancer screening (Pap test) is recommended for all women aged 21 to 65 if:  

• They are sexually active
• They have been sexually active in the past